Quantitative Flow Ratio- vs Angiography-Guided Percutaneous Coronary Intervention: A Secondary Analysis of the FAVOR III China Trial

Importance: Whether the association of quantitative flow ratio (QFR)-guided percutaneous coronary intervention (PCI) with long-term outcomes differs according to multivessel disease (MVD) status is uncertain.

Objective

To assess the association of QFR-guided vs angiography-guided PCI with 3-year outcomes according to MVD status. Design, setting, and participants: In this prespecified secondary analysis of the FAVOR III China randomized clinical trial, patients were screened across 26 centers in China from December 25, 2018, to January 19, 2020. Eligible participants were adults undergoing PCI for stable or unstable angina or for myocardial infarction (MI) occurring at least 72 hours before screening who had at least 1 lesion with 50% to 90% diameter stenosis in a vessel of 2.5 mm or larger. The analysis compared QFR-guided with angiography-guided PCI according to MVD status. MVD was defined by involvement of at least 2 epicardial vessels or the left main coronary artery. The primary analyses of the current prespecified secondary analysis were completed in October 2024.